Vice President JD Vance has formally requested a Justice Department investigation into hospitals accused of improper billing practices related to gender-affirming care for minors. As the head of the White House Anti-Fraud Task Force, Vance cites a report released Thursday by the Department of Health and Human Services that claims medical facilities used misleading diagnostic codes to secure insurance coverage for these procedures.
The report, titled Wolves in White Coats, suggests that some providers utilized incorrect billing codes—such as those for endocrine disorders or precocious puberty—to justify the administration of puberty blockers and hormone therapies. The document alleges this practice occurred across more than 30 hospitals and pharmacies, with nearly $50 million in insurance claims identified in a decade-long analysis from 2015 to 2025.
This push follows a recent decision by the Centers for Medicare and Medicaid Services to block federal funding for gender-affirming care in youth settings. The administration argues that these billing patterns represent a pattern of financial misconduct designed to inflate reimbursements from private insurers and public programs like Medicare and Medicaid.
Leading medical organizations, including the American Medical Association and the American Academy of Pediatrics, maintain that these government restrictions are clinically baseless and harmful to patients. These groups contend that limiting access to care creates a dangerous precedent for medical practice and threatens the well-being of families across the country.
The Justice Department confirmed receipt of the referral and stated it will review the allegations to determine if federal laws or policies were violated. While the department has previously settled cases involving improper diagnosis coding in Medicare Advantage plans, it remains to be determined whether the specific billing issues noted in the HHS report constitute intentional fraud or systemic administrative errors.